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Cardiogenic shock

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https://www.readbyqxmd.com/read/27932428/delayed-ventricular-septal-rupture-complicating-anterior-wall-myocardial-infarction
#1
Rajdip Dulai, Aye Hline, Mahvesh Rana Javaid, Javed Akhtar
A 59-year-old woman was admitted to our hospital with acute pulmonary oedema and cardiogenic shock 35 days after anterior ST elevation myocardial infarction. She developed a new loud pan systolic murmur. Echocardiography revealed a ventricular septal rupture with a significant left to right shunt. She was immediately transferred to the local cardiothoracic unit where she underwent a successful ventricular septal defect (VSD) repair. Ventricular septal rupture often presents within the first 24 hours of acute myocardial infarction and is rare thereafter...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27932426/extracorporeal-membrane-oxygenation-for-hemodynamic-support-of-ventricular-tachycardia-ablation
#2
Francesca Baratto, Federico Pappalardo, Teresa Oloriz, Caterina Bisceglia, Pasquale Vergara, John Silberbauer, Nicolò Albanese, Manuela Cireddu, Giuseppe D'Angelo, Ambra Licia Di Prima, Fabrizio Monaco, Gabriele Paglino, Andrea Radinovic, Damiano Regazzoli, Simona Silvetti, Nicola Trevisi, Alberto Zangrillo, Paolo Della Bella
BACKGROUND: We report the experience in a cohort of consecutive patients receiving extracorporeal membrane oxygenation during catheter ablation of unstable ventricular tachycardia (VT) at our center. METHODS AND RESULTS: From 2010 to 2015, extracorporeal membrane oxygenation was initiated in 64 patients (average age: 63±15 years; left ventricular ejection fraction in 27±9%; cardiogenic shock in 23%, and electrical storm in 62% of patients) undergoing 74 unstable VT catheter ablation procedures...
December 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27931654/the-response-of-the-microcirculation-to-mechanical-support-of-the-heart-in-critical-illness
#3
REVIEW
Sakir Akin, Atila Kara, Corstiaan A den Uil, Can Ince
Critical illness associated with cardiac pump failure results in reduced tissue perfusion in all organs and occurs in various conditions such as sepsis, cardiogenic shock, and heart failure. Mechanical circulatory support (MCS) devices can be used to maintain organ perfusion in patients with cardiogenic shock and decompensated chronic heart failure. However, correction of global hemodynamic parameters by MCS does not always cause a parallel improvement in microcirculatory perfusion and oxygenation of the organ systems, a condition referred to as a loss of hemodynamic coherence between macro- and microcirculation (MC)...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27928595/-left-ventricular-unloading-in-cardiogenic-shock
#4
A Schäfer, J Bauersachs
Cardiogenic shock is an acute life-threatening condition, which results in impaired end-organ perfusion and oxygenation. Invasive ventilation and medicinal treatment with inotropes or vasopressors are necessary in most cases; however, they are also associated with reduced long-term prognosis. Frequently, medical treatment is not even sufficient to stabilize the patient; therefore, dedicated mechanical circulatory support devices that actively reduce the load on the left ventricle were developed to allow myocardial recovery or to gain time until definitive treatment...
December 7, 2016: Herz
https://www.readbyqxmd.com/read/27928583/incidence-laboratory-detection-and-prognostic-relevance-of-hypoxic-hepatitis-in-cardiogenic-shock
#5
Christian Jung, Georg Fuernau, Ingo Eitel, Steffen Desch, Gerhard Schuler, Malte Kelm, Volker Adams, Holger Thiele
BACKGROUND: Despite the improvement of therapeutic options for patients in acute myocardial infarction (AMI), cardiogenic shock (CS) remains a complication with high mortality rates. Organ failure centrally determines the prognosis of these high-risk patients. Aim of the current study was to assess the incidence of hypoxic hepatitis (HH) in CS, its laboratory detection evaluating novel and established biomarkers and to estimate the prognostic relevance of HH in current clinical practice...
December 8, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27928254/diagnosing-myocardial-contusion-after-blunt-chest-trauma
#6
REVIEW
Zahra Alborzi, Vahid Zangouri, Shahram Paydar, Zahra Ghahramani, Masih Shafa, Bizhan Ziaeian, Mohammad Reza Radpey, Armin Amirian, Shahin Khodaei
A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs) and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27928224/clinical-outcomes-of-elderly-south-east-asian-patients-in-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#7
Jieli Tong, Wen Wei Xiang, An Shing Ang, Wen Jun Sim, Kien Hong Quah, David Foo, Paul Jau Lueng Ong, Hee Hwa Ho
OBJECTIVE: To evaluate the clinical characteristics and in-hospital outcomes of elderly South-East Asian patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: From January 2009 to December 2012, 1268 patients (86.4% male, mean age of 58.4 ± 12.2 years) presented to our hospital for ST-elevation myocardial infarction (STEMI) and underwent PPCI. They were divided into two groups: elderly group defined as age ≥ 70 years and non-elderly group defined as age < 70 years...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27922888/experience-with-extracorporeal-life-support-for-cardiogenic-shock-in-the-older-population-over-70-years-of-age
#8
Margaux Pontailler, Pierre Demondion, Guillaume Lebreton, Jean-Louis Golmard, Pascal Leprince
The both aims of this single-centre, retrospective study were to analyse the outcomes and to identify the independent predictors of 30-day and long-term mortality in case of cardiopulmonary resuscitation requiring extracorporeal life support (ECLS) in the elderly.From October 2004 to May 2014, 163 patients with a mean age of 75.5 years [range 70-91] required veno-arterial ECLS. The main indication was post-cardiotomy cardiogenic shock (79.6%). ECLS duration averaged 5.6 ± 4.3 days. Thirty-day mortality was 72% (n=117) and follow-up survival rate was 14...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27920021/venous-and-arterial-air-embolism-a-rare-phenomenon-with-fatal-consequences
#9
Jatan Shah, Nasheena Jiwa, Natasha Mamdani, David Hill
Air embolism is often an iatrogenic complication which may occur in venous or arterial circulation depending on the port of entry. We present two cases in which air embolism occurred in venous and arterial circulation after contrast medium injection (CMI) and coronary artery bypass graft (CABG) surgery, respectively. In one case, accumulation of air bubbles was observed in the pulmonary artery after CMI. This was attributed to inadvertent injection of air owing to improper connection of the injector and the catheter...
December 5, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27916741/design-and-principle-of-operation-of-the-heartmate-phptm-percutaneous-heart-pump
#10
N M Van Mieghem, Joost Daemen, Corstiaan den Uil, Onur Dur, Linda Joziasse, AnneMarie Maugenest, Keif Fitzgerald, Chris Parker, Paul Muller, Robert-Jan van Geuns
The HeartMate PHP (Percutaneous Heart Pump) is a second-generation transcatheter axial flow circulatory support system. The collapsible catheter pump is inserted through a 14F sheath, deployed across the aortic valve expanding to 24F and able to deliver up to 5L/min blood flow at minimum hemolytic risk. As such this device may be a valuable adjunct to percutaneous coronary intervention (PCI) of challenging lesions in high-risk patients or treatment of cardiogenic shock. This technical report discusses: (i) the HeartMate PHP concept, (ii) the implantation technique, (iii) the hemodynamic performance in an in vitro cardiovascular flow testing setup and (iv) preliminary clinical experience...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27909767/interventional-therapies-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#11
S de Waha, S Desch, G Fuernau, J Pöss, J Ledwoch, A Jobs, I Eitel, H Thiele
Cardiogenic shock remains the most common cause of death in patients with acute myocardial infarction. Early revascularization of the infarct-related artery has been shown to reduce mortality and is the therapeutic cornerstone. The optimal revascularization strategy of additional non-culprit lesions remains yet to be determined. Further, uncertainties exist with respect to access site choice, antiplatelet regimen as well as mechanical support devices. This review outlines current evidence on the interventional management of cardiogenic shock complicating acute myocardial infarction...
December 1, 2016: Herz
https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#12
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27904102/manifestation-of-latent-left-ventricular-outflow-tract-obstruction-in-the-acute-phase-of-takotsubo-cardiomyopathy
#13
Kazuyuki Ozaki, Takeshi Okubo, Komei Tanaka, Yukio Hosaka, Keiichi Tsuchida, Kazuyoshi Takahashi, Hirotaka Oda, Tohru Minamino
Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27896787/extracorporeal-membrane-oxygenation-for-pheochromocytoma-induced-cardiogenic-shock
#14
Guillaume Hekimian, Fatima Kharcha, Nicolas Bréchot, Matthieu Schmidt, Cécile Ghander, Guillaume Lebreton, Xavier Girerd, Christophe Tresallet, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes, Charles-Edouard Luyt
BACKGROUND: Pheochromocytoma, a rare catecholamine-producing tumor, might provoke stress-induced Takotsubo-like cardiomyopathy and severe cardiogenic shock. Because venoarterial-extracorporeal membrane oxygenation (VA-ECMO) rescue of pheochromocytoma-induced refractory cardiogenic shock has rarely been reported, we reviewed our ICU patients' presentations and outcomes. METHODS: All pheochromocytoma-induced refractory cardiogenic shock cases managed with VA-ECMO (January 2007-March 2015) were prospectively included and reviewed...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27895342/innovations-in-cardiovascular-care-historical-perspective-contemporary-practice-recent-trends-and-future-directions
#15
Hasanat Sharif, Mayera Tufail
Cardiovascular diseases continue to be a major cause of mortality and morbidity in the world population. First open heart procedure was performed by Gibbon in 1953, since then many advancements have been introduced to the field of cardiac surgery. Minimally invasive techniques were introduced, which include minimally invasive coronary artery bypass grafting (CABG), off-pump technique, minimally invasive valve surgery or transcatheter techniques to implant stentless or sutureless valves. The hybrid strategy to address coronary disease combines catheterisation procedures with standard surgical techniques...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27892719/is-a-pulse-absolutely-necessary-during-cardiopulmonary-bypass
#16
Gengo Sunagawa, Marijan Koprivanac, Jamshid H Karimov, Nader Moazami, Kiyotaka Fukamachi
The benefits and disadvantages of pulsatility in mechanical circulatory support devices have been argued since before the first use of cardiopulmonary bypass (CPB) with a nonpulsatile pump. The debate over the superiority of either pulsatile or nonpulsatile perfusion during CPB persists, but recently, the evidence in favor of pulsatile perfusion during CPB is increasing. Complications associated with chronic nonpulsatile flow in patients implanted with left ventricular assist devices have renewed interest in generating pulsatility with these devices...
November 28, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#17
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27885669/occult-adrenocortical-carcinoma-and-unexpected-early-childhood-death
#18
Mark Pilla, John Gilbert, Lynette Moore, Roger W Byard
A four-year-old previously well boy collapsed unexpectedly and was taken immediately to hospital, where he developed seizures and cardiogenic shock with lethal, rapidly progressing multi-organ failure. At autopsy, the height was >90th percentile and there were indications of early virilization. Internally, a friable tumor of the left adrenal gland was identified that had invaded the left renal vein and inferior vena cava. Histology revealed typical features of an adrenocortical carcinoma with aggregated trabeculae of cells containing abundant eosinophilic cytoplasm and large pleomorphic nuclei...
November 25, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27885393/erratum-to-venoarterial-extracorporeal-membrane-oxygenation-for-cardiac-arrest-cardiogenic-shock
#19
Anders Aneman, Peter Macdonald
No abstract text is available yet for this article.
November 24, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27884422/a-new-risk-score-to-predict-long-term-cardiac-mortality-in-patients-with-acute-myocardial-infarction-complicated-by-cardiogenic-shock-and-treated-with-primary-percutaneous-intervention
#20
Ruben Vergara, Renato Valenti, Angela Migliorini, Giampaolo Cerisano, Nazario Carrabba, Letizia Giurlani, David Antoniucci
Poor data exist about predictors of long-term cardiac mortality in patients presenting acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) treated with primary percutaneous coronary intervention (p-PCI), and current risk-adjustment models in this setting are not adequate. We retrospectively analyzed our registry of patients with AMI treated with p-PCI. The aim of this study was to identify the independent predictors of 2-year cardiac mortality in patients presenting CS. A Risk Score was created assigning at any independent variable a value directly correlated with its power to increase mortality...
November 1, 2016: American Journal of Cardiology
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